Ex vivo evaluation of a technique for equine jejunocecal anastomosis using radiofrequency thermofusion and a Cushing oversew.
Authors: Gandini Marco, Cerullo Anna, Gallo Livio, Iussich Selina, Minoli Lucia, Giusto Gessica
Journal: Veterinary surgery : VS
Summary
# Radiofrequency thermofusion for equine jejunocecal anastomosis: a promising but cautious technique Jejunocecal anastomosis is occasionally required in equine colic surgery, yet the optimal construction method remains unclear. Gandini and colleagues conducted an ex vivo study using intestinal tissue from 24 horses to evaluate a novel radiofrequency thermofusion technique (supported by a Cushing oversew) against established handsewn and stapled methods, measuring construction time and bursting pressure as indicators of anastomotic integrity. The radiofrequency technique required a median 15.8 minutes—significantly faster than handsewn (25.5 minutes) but slower than stapled (10.8 minutes)—whilst achieving a bursting pressure of 76 mmHg, which exceeded stapled anastomoses (48 mmHg) but fell substantially short of handsewn repairs (153 mmHg). Histologically, thermal damage from the device remained confined within the suture line in deeper tissue layers but extended several millimetres beyond the anastomotic site on the serosa, raising concerns about adhesion formation postoperatively. Whilst the radiofrequency method shows promise as a middle ground between speed and strength, the off-label device use and thermal serosal injury mean further in vivo investigation is essential before clinical adoption can be recommended; handsewn techniques remain superior for burst strength if time permits.
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Practical Takeaways
- •Radiofrequency thermofusion for intestinal anastomosis is not faster than traditional hand-sewn techniques and produces weaker anastomoses, limiting its clinical advantage
- •Serosal thermal damage from radiofrequency devices may increase post-operative adhesion formation risk, a significant concern for equine colic surgery outcomes
- •Hand-sewn anastomoses remain superior for critical intestinal repairs where burst strength is essential, despite longer operative time
Key Findings
- •Radiofrequency thermofusion anastomosis construction time (15.8 min) was similar to hand-sewn technique (25.5 min) but longer than stapled technique (10.8 min)
- •Hand-sewn anastomoses had significantly higher bursting pressure (153.1 mmHg) compared to radiofrequency (76 mmHg) and stapled (48 mmHg) techniques
- •Radiofrequency thermofusion caused thermal damage extending beyond the suture line into the serosa, which may increase adhesion risk
- •Radiofrequency-assisted anastomoses showed superior bursting pressure compared to stapled anastomoses but inferior to traditional hand-sewn technique